Claim total
$767.69
base $93.83 · payer covered $429.31
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-31
- Stop
- 2024-01-31
The parties
- Patient
- patient Lorilee Rau
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
01b2da20-8b0d-5eee-0bfe-ec39fed30ae1